The mission of NCI CTEB is to develop a comprehensive program of epidemiologic research in genomic factors that influence cancer, recurrence, survival, and treatment. The mission of the VA CHOIR is to study the implementation of evidence-based practices that improve health outcomes for Veterans. Dr. Lynch, an investigator at CHOIR, has developed a program of research to study implementation of cancer genomics. Genetic diagnostic testing and molecularly targeted pharmaceutical treatments have become important components of quality cancer care. Genomic applications have been increasing at an exponential rate. Proper use of cancer genomics has the potential to significantly improve health outcomes while decreasing costs and toxicities associated with ineffective treatments for patients. Yet, efforts to evaluate dissemination, implementation, and health outcomes research of cancer genomics have been hampered by difficulties identifying cancer genomics in Medicare claims. There is also be a lack of expertise in genomics health services research. NCI CTEB and VA CHOIR have recently initiatiated efforts to expand and facilitate research to evaluate implementation of cancer genomics. One component of NCI?s effort is to publish an annual report to the nation on implementation of cancer genomics. One component of the VA CHOIR effort is to establish an accurate and timely dataset (VA GDx) to identify utilization of genetic tests in Veterans nationally.